Objective Nursing innovation significantly enhances the quality, efficiency, and effectiveness of nursing services, enabling nurses to cultivate a sense of occupational accomplishment and strengthen their professional competence. Previous studies only examined the factors of nurses’ innovative behaviors, and these factors were not ranked according to their importance. The purpose of this study is to identify the most important influencing factors that different categories of nurses’ innovative behaviors using comprehensive measures based on the conservation of resources theory. Methods From August to December 2024, the survey was conducted among 832 nurses from 6 public tertiary hospitals in China. The data were analysed using Latent Profile Analysis, Pearson’s χ 2 test, ANOVA and the random forest algorithm. Results Overall, this study identified three subgroups of nurses’ innovative behavior: Innovation-Conservative, Innovation-Exploratory, and Innovation-Driven. Moreover, adequate creative self-efficacy, work engagement, and paradoxical leadership are the most important factors influencing all subgroups of nurse innovative behavior. However, the importance of secondary factors varied; for example, working years and average monthly income were critical for the Innovation-Conservative, while scheduling satisfaction was a key factor for Innovation-Exploratory. Additionally, innovative experience ranks relatively low. Conclusion The innovative behaviors of nurses are slightly above the average of previous studies. Nursing managers should first enhance their paradoxical leadership to improve nurses’ creative self-efficacy and work engagement. Then, targeted intervention measures are implemented based on the characteristics of each group to enhance the professional quality and economic security of Innovation-Conservative and provide flexible and humanized scheduling for the Innovation-Exploratory, thereby effectively promoting the innovation of the entire nursing team.
Zhu et al. (2026) studied this question.